Objectives To investigate the association between health belief and medication adherence in hypertensive patients.Methods A total of 232 hypertensive patients who visited Outpatient Department of Huashan Hospital between October 2013 and May 2014 were recruited in this cross-section study.The degree of medication adherence was measured with Morisky scale and health belief was evaluated with questionnaires of Health Belief Model (HBM).Results Of the 232 participants,61 (26.3％),51 (22.0％) and 120 (51.7％) showed low,medium and high medication adherence in Morisky scale,respectively.Logistic analysis showed that the perceived susceptibility (P ＜ 0.001),and cues to action (P =0.004) were positively correlated,and perceived barriers (P ＜ 0.001) was negatively correlated with medication adherence of patients.Conclusion Effective interventions to improve antihypertensive medication adherence should increase perceived susceptibility,cues to action,and reduce the barriers to medication adherence of patients.

Background and purpose:In in vivo and vitro studies, Rhodiola shows anti-cancer effect, but there were few reports about the effects of Rhodiola on growth of breast cancer and its possible mechanism. Methods:Xenograft of Human breast cancer cells MDA-MB-435 in female BALB/c nude mice were treated with and without Rhodiola extracts. The tumor volume and proliferation index (PCNA and Ki67) of the xenograft were studied.Results:After Rhodiola was given to nude mice for 4 weeks, the mean tumor volume was smaller (99.95mm 3 vs. 174.60mm 3 ) compared to untreated group,but there was no statistical significance(P=0.535). The proportion and intensity of cellular Ki-67 staining in Xenografts were decreased as compared to the untreated group, (average H-score 152.8 vs. 86, P=0.014), the same trend could be found for cellular PCNA staining, but there was no statistical significance(242 vs.210,P=0.221).Conclusions:The mechanism of anti-cancer effect of Rhodiola may be partly through inhibiting the proliferation of cancer cells in vivo.

Objective:To investigate the clinic-cytology and histopathology of non-Hodgkin lymphoma (NHL) in breasts. Mothods:Twelve cases of NHL of the breast were studied by fine-needle aspiration biopsy (FNAC), histopathology and immunohistochemistry, and whose clinical data were analysed at the same time. Results:In 12 cases of NHL, 3 cases were T-cell NHL and 9 cases were B-cell NHL. Cytologically, the T-cell NHL cells were mostly arranging in diffuse patterns. The tumor cells were oval and pleomorphism. Some of them had distorted nucleus and thin nuclear envelope.The nucleus showed irregular course chromatin and visible nueleoic. Histopathologically, some of the tumor cells distributed around the blood vessels, and there was an obvious phenomenon of “blood-vessel-closing”. B-cell lymphoma cells were arranginy in diffuse pattern, and showed round and ellipse in shape with a clot and course granular chromatin and visible nueleoic and karyoknesis. Lymphoepithelia lesions were seen. Immunohistochemistry showed that CD3, CD43, and CD 45RO in T-cells NHL were positive.CD20, CD74 and CD79a in B-cells NHL were negative. CK, EMA, ER and PR in NHL were all negative. Conclusion:NHL of breast is extremely rare, and its definite diagnosis depends on various examination methods.

Objective: To investigate the advantage of ThinPrep cytological test in tumor diagnosis by fine needle aspiration cytology. Methods: Using fine needle aspiration for smears,some of smears were made in conventional smears,the remains aspirating needles were washed with a transport washing solution.ThinPrep slides were made using the ThinPrep Processor. Results: In 84 cases FNA samples,49 cases were breast,29 cases were lymph node and 6 cases were others.Comparing with conventionally prepared specimens,ThinPrep processed samples showed the advantage in sensitivity or specificity.The lack of cellular debris,blood and exudates improve the ability to detect cellular abnormalities and speed up the time required for screening in ThinPrep processed samples.Rapid cell transfer from the sampling device to the transporing fluid containing the fixative ensure preservation of cell details with minimal artifactual changes. Conclusion: The use of Thinprep and by combination of FNAC and immunocytochemistry cytopathological diagnosis can be improved significantly.

Objective:To investigate the relationship between tumor necrosis factor-α (TNF-α)-308A/G gene polymorphism and mild cognitive impairment(MCI)in patients with type 2 diabetes mellitus(T2DM),and their correlative risk factors thereof.Methods:Forty cases of T2DM with MCI and 80 cases of T2DM without MCI were selected for this study.The polymorphism of the TNF-α-308A/G was detected by PCR-restriction fragment length polymorphism (PCR-RFLP).According to the clinical data,such as course of disease,plasma glucose,plasma fat and body mass index(BMI),the independent risk factors of T2DM and MCI were analyzed by non-conditional logistic regression.Results:The frequency of TNF-α2 allele was significantly higher in the group of T2DM with MCI than that without MCI (P＜0.01).The indexes of the statistical significant difference between the two groups were the age,course of disease,postprandial blood glucose(P2BG),glycosylated hemoglobin,body mass index,family history of T2DM,hypertension,diabetic retinopathy,diabetic peripheral neuropathy and TNF-α.The independent risk factors included TNF-α,diabetic peripheral neuropathy,diabetic retinopathy,age and P2BG.Conclusion:There is a significant relationship between TNF-α2 allele and T2DM with MCI.There is a significant relationship between the age,control of plasma glucose and microvaseular complication of T2DM with the cognitive funotion.

Objective To investigate the relationship between apolipoprotein E(Apo E) gene poly-morphism and mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus (T2DM), and e-valuate the correlative risk factors. Method 40 cases of type 2 diabetes with MCI and 80 cases of type 2 diabetes without MCI were enrolled in this study. The polymorphism of the Apo E gene was detected by PCR-restriction fragment length polymorphism(PCR-RFLP). According to the clinical data such as course of disease, plasma glucose, plasma fat and body mass index (BMI), the independent risk factors of T2DM and MCI were analyzed by non-conditional logistic regression. Results The frequency of Apo E ε_4 allele in the group of type 2 diabetes with MCI was higher than that without MCI ( 25.0% vs 10. 0% ), and the difference had statistical significance( P < 0. 01 ). The indexes of the statistical significant difference be-twcen the two groups were age, course of disease, postprandial blood glucose ( P2BG), HBA1C, BMI,family history of T2DM, hypertension, diabetic retinopathy, diabetic peripheral neuropathy, Apo E gene. The independent risk factors included diabetic retinopathy ( OR = 3. 452, P < 0. 05 ), diabetic peripheral neuropathy( OR = 3. 252, P <0. 05), Ape E gene( OR = 2. 441, P < 0.01 ), HBA1C ( OR = 1. 372, P <0.05), P2BG(OR = 1. 194, P <0.05), age(OR = 1. 194, P <0.01) and course of disease(OR =1. 142, P <0. 05). Conclusion Apo E ε_4 allele has significant relationship with T2DM and MCI. The age, course of disease, control of plasma glucose, and microvascular complication of diabetes have relation-ship with the cognitive function.

Objectives:To assess bowel function and quality of life in patients with ulcerative colitis (UC)after ileal pouch anal anastomosis (IPAA).Methods:Clinical data of 37 UC patients after IPAA between 2014 and 2017 were retrospectively analyzed at Sir Run Run Shaw Hospital School of Medicine Zhejiang University. The IBDQ and Bowel Function questionnaire were used for analyzing correlation between clinical variables and quality of life or bowel function.Results:Laparoscopic operation was performed in 12 cases at stage 2 and 25 cases at stage 3. Postoperative defecation of stage 3 patients were better than that of stage 2 ( t=6.72, P<0.05). The number of daily defecation in age >45-year-old group was more than that in <45-year-old ( t=3.49, P<0.05), and the rate of evening stool seepage in the older group was higher than in the younger group( t=5.28, P<0.05). The total score of intestinal symptoms of IBDQ in patients of pouchitis was lower than that without pouchitis ( r=0.330, P<0.05). The total score in age >45 in terms of systemic symptoms ( r=0.349, P<0.05) and emotional function ( r=0.379, P<0.05) was higher than age <45. Conclusions:Outcomes of UC patients after IPAA are satisfactory, bowel function and quality of life is related with age, and stage of IPAA affect postoperative defecation.

Objective To investigate the clinical value of Hangzhou Criteria in selection of patients with hepatocellular carcinoma(HCC)for living donor liver transplantation(LDLT)and their effects on recipient's post-transplant survival.Methods A retrospective analysis was conducted on 43 patients with HCC who underwent LDLT in our center.All of the recipients were classified into subgroups according to Milan Criteria,Up-to-Seven Criteria and Hangzhou Criteria,and post-transplant total survival rate and tumor-free survival rate were compared among the criteria.Results The number of patients within Hangzhou Criteria was 61.5 %(8/13)more than that within Milan Criteria and 23.5 %(4/17)more than that within Up-to-Seven Criteria.The 1-,and 3-years total survival rate and tumor-free survival rate of the recipients within Milan Criteria(n=13)were 100 %,80.0 % and 84.6 %,84.6 %,those of the recipients within Up-to-Seven Criteria(n=17)were 100 %,75.2 % and 87.5 %,81.2 %,and those of the recipients within Hangzhou Criteria(n=21)were 100 %,80.0 % and 89.5 %,84.2 %,respectively.There was no significant difference among the three criteria in total survival rate and tumor-free survival rate(P>0.05).Conclusion Hangzhou Criteria further enrolled more liver transplantation candidates without decline of total survival rate and tumor-free survival.It is a more effective selection of HCC recipients for LDLT.

Objective To evaluate the feasibility and safety of laparoscopy in complex Crohn's disease.Methods A retrospective study of patients with complex Crohn's disease from Jan 2013 to Dec 2015 was conducted.The clinical data and the surgical outcome were evaluated.Results 137 patients with complex Crohn's disease were involved in the study.81 patients underwent laparoscopic procedure,the conversion rate was 30％.56 patients underwent conventinal laparotomy.The blood loss (50ml vs.100 ml,Z =-4.84,P ＜ 0.001),stoma rate (28％ vs.45％,x2 =6.03,P =0.05),interval to bowel movement (3 d vs.4 d,Z=-3.69,P =0.001) and postoperative hospital stay (8 d vs.14 d,Z=-5.41,P＜0.001) were more favourable in laparoscopic surgery group than in laparotomy group.Conclusion Laparoscopy is feasible and safe in complex Crohn's disease.In well indicated patients,preoperative optimization and surgical expertise can improve the outcome of Crohn's disease.

The importance of follower loads in maintaining spine biomechanics was described, and the various methods and means of follower load simulations of human spine specimens in vitro in recent years were summarized. By comparison with the real data of range of motion (ROM) and intervertebral disc pressure of human vertebral body, the feasibility of various simulation methods was analyzed from the perspectives of mechanics, and the optimal loading load and torque of human cervical, thoracic and lumbar vertebrae biomechanical experiments were summarized. The effects of conventional spinal internal fixation on biomechanical properties of the spine were also discussed.